Archived: Newmarket Road Surgery

Updated 17 December 2015

Newmarket Road Surgery provides general medical services to approximately 6000 patients living in the south of Norwich and the surrounding area. The population the practice serves consists of a higher percentage than average (against both local and national figures) of patients aged 45 and over and lower than averages for patients aged 44 and below.

The premises consist of a converted residential grade two listed building with treatment and consultation rooms on ground and first level. Limited parking is available with level access to the surgery. Entrance doors are automatic and spacious.

The practice has a team of four GPs, male and female, meeting patients’ needs. These GPs are partners, meaning they hold managerial and financial responsibility for the practice. There are two practice nurses and one health care assistant, with an additional health care assistant being recruited at the time of our inspection.

There is a practice manager and an office manager with a team of six administrative, secretarial and reception staff who share a range of roles; two of the receptionists also work one morning a week each as phlebotomists in the surgery. The practice also hosts other services, for example community midwives run sessions weekly at the practice.

The practice provides a range of clinics and services, most of which are detailed in this report, and operates generally between the hours of 08:30 and 18:00, Monday to Friday. Appointments with GPs were from 08:50 to 12:30 and 16:00 to 18:00 every weekday, with late appointments until 19:30 on Monday. Nurse and health care assistant appointments were from 08:30 to 13:00 and 14:00 to 17:30 every weekday. Pre-bookable appointments could be booked up to seven weeks in advance with GPs and eight weeks in advance with nurses and health care assistants; urgent appointments were available for people that needed them.

Outside of these hours, medical care is provided by Integrated Care 24 Limited (IC24). Primary medical services are accessed through the NHS 111 service.

Updated 17 December 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Newmarket Road Surgery on 20 October 2015. The overall rating for this practice is good. Specifically, we found the practice to be good for providing safe, effective, caring and well led services. It was also good for being responsive.

It was good for providing services for the care experienced by older people, by people with long term conditions and by families, children and young people. Working age people, those in vulnerable circumstances and people experiencing poor mental health also received good care. Our key findings across all the areas we inspected were as follows:

• The practice was a friendly and caring practice that addressed patients’ needs and it worked in partnership with other health and social care services to deliver individualised care.

• Patients’ needs were assessed and care was planned and delivered following best practice guidance.

• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.

• Information about services and how to complain was available and easy to understand.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• There was a clear leadership structure and staff felt supported by management.

We saw several areas of area of outstanding practice:

• The practice used dementia friendly signs and images throughout the premises.

• One of the GP partners, who was on long term sick, was present on the day of the inspection to spend time with our advisors and answer any questions we had. This reflected the care and interest this GP, and other staff invested in their practice.

• Staff commented on good training and development opportunities and felt well supported by the GPs and management.

However there were areas of practice where the provider needs to make improvements. Importantly the provider should:

• Undertake regular fire drills.

• Carry out risk assessments to ensure a safe practice environment is maintained.

• Effectively record audit procedures for infection prevention and control.

• Improve complaint recording. When we reviewed the significant events we noticed that there were some incidents recorded that could have been logged as a complaint but weren’t.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 17 December 2015

The practice is rated as good for the care of people with long-term conditions. Patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the staff worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 17 December 2015

The practice is rated as good for the care of families, children and young people. Immunisation rates were in line or just below local averages for all standard childhood immunisations. Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals. Appointments were available outside of school hours and the premises were suitable for children and babies with toys available. Weekly ante-natal clinics were held by a visiting midwife and a private space for breastfeeding was available.

Updated 17 December 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits to avoid older people needing to use a taxi; in addition it offered home flu vaccinations or would pick up prescriptions for patients if these were urgently needed. On Mondays the practice had a dedicated GP for visits only so that there would be no outstanding visits after the morning surgery. The practice had 101 admission avoidance plans in place at the time of our inspection.

Updated 17 December 2015

The practice is rated as good for the care of working-age people (including those recently retired and students). The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care. The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group. Telephone consultations were available. Minor surgery was accessible at the practice avoiding the need to attend other healthcare locations. Flu clinics were also held on Saturdays.

Updated 17 December 2015

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia. It carried out advance care planning for patients with dementia.

The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations. It had a system in place to follow up patients who had attended accident and emergency (A&E) where they may have been experiencing poor mental health. Staff received additional training on how to care for people with mental health needs and dementia. In the last 12 months prior to our inspection 30 out of 42 eligible patients had had their care plan reviewed.

Updated 17 December 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients living in vulnerable circumstances including those with a learning disability. At the time of our inspection the practice had 15 patients on its learning disability register.

Performance for palliative care related QOF indicators was better at 100% than the national average of 97.6% and in line with the local average.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told vulnerable patients about how to access various support groups and voluntary organisations. Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.